Philipp et al reported clinical findings associated with a bleeding disorder underlying menorrhagia in a woman. These can help to identify patients who should undergo further testing. The authors are from UMDNJ-Robin Wood Johnson Medical School in New Jersey and the National Center on Birth Defects and Developmental Disabilities at CDC.

Patient selection: woman with menorrhagia


Clinical findings suggesting an underlying bleeding disorder:

(1) duration of menses >= 7 days AND one of the following:

(1a) "flooding"

(1b) impairment in daily activities during most periods

(2) history of being treated for anemia

(3) family history of a diagnosed bleeding disorder

(4) a history of excessive bleeding following a stimulus (tooth extraction, surgery, delivery, miscarriage)



• minimum number of findings present: 0

• maximum number of findings present: 4

• The presence of one or more findings was considered positive.



• The criteria for a history of being treated for anemia may be nonspecific.

• Some patients may have a family history of a bleeding disorder that has not been officially diagnosed. A patient may have a relative with a bleeding disorder that is acquired and not hereditary.


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